Mary Simmons Kinder, MA; PLPC; PLCAS; ABD

Primary specialty

CounselorTaxonomy code 101Y00000X

License

PROVISIONAL Issued in NC

Practice address

1500 Bragg Blvd
Fayetteville, NC 28301-4889

Phone

(910) 484-1500

Fax

(910) 223-1505

NPI assigned

Feb 18, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pathways to Empowerment Counseling Center

  • Professional Counselor
  • Fayetteville, NC
  • NPI 1710145875
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1750520581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 CULBRETH RD",
            "city": "EASTOVER",
            "state": "NC",
            "postal_code": "283127578",
            "telephone_number": "910-740-4736",
            "fax_number": "910-223-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BRAGG BLVD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014889",
            "telephone_number": "910-484-1500",
            "fax_number": "910-223-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDER",
        "first_name": "MARY",
        "middle_name": "SIMMONS",
        "name_prefix": "Mrs.",
        "credential": "MA; PLPC; PLCAS; ABD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "PROVISIONAL",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "PROVISIONAL",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Kim, MD
• Jody Sook Kim, L.AC.,OMD
• Joonsung Kim
• Michael S. Kim, OTR/L
• Suzanne Teresa Kim
• Kindred Care Therapy
• Kindred Spirit Counseling Services PLLC
• Carolyn Laura Kindred, LCMHC
• Canosha King McAllister
• Ashley Jane King, LCMHCA

• Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.